Ogurusu K, Takahashi K, Soda R, Araki M, Sunami K, Takeda K, Kozuka A, Katagi S, Yamagata K, Kimura I
Second Department of Medicine, Okayama University Medical School.
Arerugi. 1992 Jan;41(1):7-14.
To clarify the factors which induce intractable asthma, the level of serum IgG subclass antibodies to mite (Dermatophagoides farinae) and Candida antigens (Candida albicans) for aging and severity was investigated in 230 bronchial asthmatics (Male: 117, Female: 113) aged 6-81 years old (mean age = 40). Total IgE level and IgE antibodies to mite and Candida antigens were measured by radioimmunosorbent test (RIST) and radioallergosorbent test (RAST), respectively. The serum level of IgG and IgG1 antibodies to the antigens were measured by enzyme-linked immunosorbent assay (ELISA). The results were as follows: 1) The incidence of severe asthma in aged and late onset asthmatics, especially late onset intractable asthma (LOIA), was higher than that in young and early onset asthmatics. 2) The serum level of total IgE and IgE antibodies to mite in aged and late onset asthmatics was lower than that in young and early onset asthmatics. 3) The incidence of severe and intractable asthmatics in the group of low IgE levels (less than 300 IU/ml) was higher than that in the group of high IgE levels (over 500 IU/ml). The incidence of positive IgE (RAST) score to mite in severe and intractable asthmatics was lower than that in mild and moderate asthmatics. 4) Considering aging, the serum levels of IgG and IgG1 antibodies to mite and Candida in severe and intractable asthmatics was higher than those in mild asthmatics. These data indicate that the aged and late onset asthmatics may produce dominantly the IgG (IgG1) antibody to the antigens, and have severe asthma attacks caused by IgG (IgG1) rather than IgE antibody.
为阐明诱发难治性哮喘的因素，我们对230例年龄在6至81岁（平均年龄 = 40岁）的支气管哮喘患者（男性117例，女性113例）进行了研究，检测其血清中针对螨（粉尘螨）和念珠菌抗原（白色念珠菌）的IgG亚类抗体水平与年龄及病情严重程度的关系。总IgE水平以及针对螨和念珠菌抗原的IgE抗体分别通过放射免疫吸附试验（RIST）和放射变应原吸附试验（RAST）进行检测。血清中针对这些抗原的IgG和IgG1抗体水平通过酶联免疫吸附测定（ELISA）进行检测。结果如下：1）老年及迟发性哮喘患者，尤其是迟发性难治性哮喘（LOIA）患者中重度哮喘的发生率高于年轻及早发性哮喘患者。2）老年及迟发性哮喘患者的总IgE水平以及针对螨的IgE抗体水平低于年轻及早发性哮喘患者。3）低IgE水平组（低于300 IU/ml）中重度和难治性哮喘患者的发生率高于高IgE水平组（高于500 IU/ml）。重度和难治性哮喘患者中针对螨的IgE（RAST）阳性评分发生率低于轻度和中度哮喘患者。4）考虑到年龄因素，重度和难治性哮喘患者中针对螨和念珠菌的IgG及IgG1抗体水平高于轻度哮喘患者。这些数据表明，老年及迟发性哮喘患者可能主要产生针对抗原的IgG（IgG1）抗体，并由IgG（IgG1）而非IgE抗体引发严重哮喘发作。
